Enhanced recovery after surgery (ERAS) has been carried out in many surgical fields such as orthopedics, galactophore, cardiothoracic surgery, gastrointestinal surgery, and obstetrics due to its standardized perioperative management process to reduce surgical stress and reduce surgical complications. After more than a decade of development, ERAS has achieved initial results. However, in China, the development of ERAS in orthopedic is still in its infancy. Most of the researches focus on the multidisciplinary management path of perioperative period. How to break through the existing bottlenecks is the key to accelerate the further development of rehabilitation. Therefore, this paper introduces the origin and development of ERAS, analyzes the challenges and opportunities of orthopedic ERAS in clinical advancement, proposes the important measures to promote the accelerated development of orthopedics, and provides new ideas for promoting the in-depth development of orthopedics accelerated rehabilitation.
ObjectiveTo explore the effect of level management model in the application of nursing for pressure ulcers after spinal surgery.
MethodA total of 3 558 patients underwent spinal surgeries between January 2014 and September 2015 were selected. We established a level management model, confirmed the personnel responsibilities, strengthened the pressure ulcers risk assessment of new inpatients, and standardized the processes of reporting pressure sores. We carried out the level management model between January and June 2014, summarized experience and formed a system file between July and December 2014, applied to the clinical work after continuous improvement between January and September 2015. High risk of pressure ulcers reporting rate, incidence of high-risk pressure ulcers, and healing rate of pressure ulcers were compared at the various stages.
ResultsThe reporting rate of pressure ulcers raised, the incidence of pressure ulcers increased and the curing rate decreased after continuous improvement (P<0.05).
ConclusionsLevel management model may effectively improve the quality of the nursing for spinal pressure ulcers.
Objective
To identify the prevalence and related factors of emotional disorder of inpatients in Department of Spinal Surgery .
Methods
A cross-sectional study was conducted from October 2015 to April 2016 to screen 300 patients undergoing spinal surgery. Huaxi Emotional-distress Index was used to assess the emotional status of the patients, and a self-designed general condition questionnaire was used to evaluate the demographic data.
Results
The prevalence of emotional disorder of patients in Department of Spinal Surgery was 14.3%. Anxiety was the main type of emotional disorder. Logistic regression analysis showed that the education level and pathogeny were the main factors of emotional disorder.
Conclusions
In Department of Spinal Surgery, the inpatients’ psychological status is poor, and anxiety is the main emotional disorder. Emotional disorder is related to education level and pathogeny. Timely psychological treatment should be used in order to comprehensively improve the level of recovery of the inpatients.
Objectives
To explore the application effect of orthopedic psychological sleep management mode based on enhanced recovery after surgery (ERAS) in orthopedic patients.
Methods
A non-synchronous clinical controlled study was conducted. The intervention group enrolled 118 orthopedic patients who admitted to our hospital between April and June 2017, and the control group enrolled 111 orthopedic patients who admitted to our hospital between January and March 2017. The control group used routine nursing measures during hospitalization, while the intervention group implemented an ERAS-based orthopedic psychological sleep management mode based on routine nursing measures, which included carrying out a new mode of multidisciplinary collaborative management, implementing the normative path of orthopedic psychological sleep management, and implementing the comprehensive psychological sleep management. The mood, sleep quality and satisfaction of the two groups within 24 hours after admission and before discharge were compared.
Results
Before the intervention, there was no statistically significant difference in general data, mood or sleep quality between the two groups (P>0.05). After the intervention, the median score (the lower and upper quartiles) of the Huaxi Emotional Index of the intervention group was 1 (0, 5), while the score of the control group was 2 (0, 6); the median score (the lower and upper quartiles) of the Pittsburgh Sleep Quality Index was 4 (3, 7) in the intervention group and 6 (4, 9) in the control group; the satisfaction score in the intervention group was better than that in the control group (96.47±2.72vs. 95.52±2.79); the differences between the two groups were statistically significant (P<0.05).
Conclusions
The ERAS-based orthopedic psychological sleep management mode is beneficial to improve the patients’ emotional disorder, sleep quality and satisfaction. It facilitates the patients’ accelerated recovery.
In recent years, reports of domestic robot-assisted total knee arthroplasty have gradually increased. In response to problems that may arise during the perioperative period, West China Hospital of Sichuan University has adopted measures such as the establishment of multidisciplinary team, adequate preoperative evaluation, precise intraoperative operations, and whole process optimization management (incision management, pain management, functional exercise and follow-up management). Combined with the actual clinical situation, a domestic robot-assisted total knee arthroplasty management program during the perioperative period was explored and formulated to promote the recovery of patients. This article introduces the above-mentioned program, and aims to provide a reference for the management optimization of domestic robot-assisted total knee arthroplasty during the perioperative period.
Objective To integrate augmented reality (AR) into the whole process of health management and observe its application effect in hip replacement patients. Methods Patients undergoing hip replacement in the Department of Orthopedic Surgery of West China Hospital, Sichuan University between April and September 2022 were selected. According to the random number table method, patients were divided into a trial group and a control group. The trial group adopted the whole process AR health management mode, and the control group adopted the conventional health education mode. The joint function score, functional exercise compliance, coping difficulties after discharge, Huaxi Emotional-distress Index and satisfaction of the two groups at different time points were compared. Results A total of 80 patients were included, with 40 patients in each group. At each follow-up time point after surgery, the scores of Harris Hip Score and Post-Discharge Coping Difficulty Scale among trial group patients were better than those of the control group patients (P<0.05). There was no statistically significant difference in the Huaxi Emotional-distress Index scores between the two groups (P>0.05). The compliance rate of functional exercise in the trial group (P=0.025) and the patient satisfaction were higher than those in the control group (Z=?4.918, P<0.05). Conclusions The AR-based whole process health management can make it easier for patients to grasp functional exercise (preoperative pre-exercise, postoperative rehabilitation), post-hospital health guidance and other educational knowledge. This new health management is conducive to enhancing patients’ exercise compliance, strengthening joint function recovery, daily living ability and patient satisfaction.It can be promoted and applied in clinical practice.
